Hidden Gallstones

Last year I was admitted to hospital with extreme internal pain in my back and my gut was also bloated due to blockage.  Gallstones were strongly suspected.

I was give two ultrasound scans, the last with the latest Philips hi-tec computerised machine. No stones could be detected. Next a CT scan. No stones found, but told my pancreas was inflammed (Chronic).  Finally, I was given an MRI scan.  I was then told that I do have 'some', 'small' stones in my gallbladder and advised to have my gallbladder removed.

"How many stones do I have and how small are they?", I asked the doctor. "Wont know that until we remove your gallbladder and cut it open", he replied.

I was shown the MRI image of my gallbladder. It was just a white sausage shaped structure.  I could not see a single stone in this image. "Where are these stones?"  The doctor just shrugged his shoulders.

I have since read that stones smaller than one and a half millimeters in diameter cannot be detected by ultrasound. Also, I read that X-rays cannot detect stones that have no calcium in them which, if there, would make them 'radioluscent' (seeable?).

But what about MRI scans?  Should an MRI image show the stones up?

Would appreciate any advice on this.  I do not want to needlessly have my gallbladder removed.

Regards

Paul

[CalGal]

It takes a darned good radiologist to be able to detect the types of stones you're probably talking about which is typically called sludge. When it is seen, it's typically found in ultrasound, but normally it is very difficult to find. You might be able to find out if you're having problems with 'expelled' sludge via a bile 'capture' during a specialized endoscopy procedure. It may or may not give you an answer.

The problem with the sludge, when present, is that it can irritate the common bile duct causing spasms. And if those spasms happen and it closes off the path of the enzyme exit from the pancreas, pancreatitis can result. But pancreatitis can also result from other causes, too.

You may want to discuss a HIDA scan with CCK injection with your doc. It's not going to answer your question, but it may indicate whether your release of bile is being compromised - perhaps by sludge.

In the meantime, I hope you're following a low fat diet. It helps in some people.